1. Field of the Invention
The present invention relates generally to the structure and use of surgical instruments. More particularly, the present invention relates to an electrosurgical device which combines a hook electrode and a reciprocatable paddle electrode intended for use in least invasive surgical procedures.
Medical treatment modalities which use electrical energy to change the structure or function of tissue or body organs is referred to generally as "electrosurgery." Electrosurgical procedures most often rely on the application of very high frequency currents to excise tissue and/or close small bleeding blood vessels by electrocauterization. Of particular interest to the present invention are monopolar electrosurgical devices where the patient is grounded and the very high frequency electrical current is applied to desired area of tissue or body organ using a specialized electrode. Electrosurgical procedures are particularly advantageous since they reduce bleeding from small blood vessels, facilitating the handling of highly vascularized tissues while minimizing exposure of the patient to shock and pain.
Least invasive surgical (LIS) techniques, such as laparoscopic, endoscopic, and arthroscopic surgery, are generally performed through small incisions using specialized instruments to perform desired surgical procedures. Usually, the instruments are introduced through a tube, such as a cannula, while the physician observes manipulation of the instruments through specialized imaging equipment, such as laparoscopes, endoscopes, and arthroscopes. Such LIS techniques offer significant advantages over conventional "open" surgical procedures. In particular, the LIS techniques are usually less traumatic, require a shorter recovery time, and are less costly than the corresponding conventional surgical techniques.
The combination of LIS and electrosurgical methodologies promises substantial advantages to both the patient and the treating physician. As described above, LIS reduces patient trauma resulting from the surgical incisions necessary to access the area of the body being treated, while the use of electrosurgical techniques reduces the trauma resulting from the interventional procedure itself.
The adaption of electrosurgical instruments for use in LIS, however, can be problematic. In particular, the incorporation of only a single, limited function in the electrosurgical instrument necessitates frequent exchange and replacement of instruments through the cannula. Such exchange can be time consuming and inefficient. Moreover, electrosurgical instruments frequently produce charred tissue which can adhere to the working surface of the instrument. Usually, such adherent debris requires that the instrument be withdrawn through the cannula and cleaned prior to reintroduction and further use. The need to repeatedly perform such cleaning is also inefficient and time consuming.
For these reasons, it would be desirable to provide improved electrosurgical instruments for use in LIS procedures where the instruments are versatile, capable of self-cleaning, and efficient in achieving their intended purpose. It would be particularly desirable to provide electrosurgical instruments capable of combining a wide variety of different electrode surfaces, such as cylinders, cones, spatulas, balls, needles, blades, hooks, loops, and the like, in a single instrument, where the different electrode surfaces are simultaneously connected to a power source in an efficient manner.
2. Description of the Background Art
French Patent Application No. 2 265 344 describes an electrosurgical hook that can be used for gynecological, ear, nose, and throat surgery. U.S. Pat. Nos. 1,798,902; 1,881,250; and 1,978,495, describe electrosurgical instruments including blades which reciprocate within a frame, which instruments are intended primarily for removing tonsils. U.S. Pat. No. 4,919,129, describes an electrocautery instrument having a self-cleaning reciprocatable electrode/blade. Other electrosurgical instruments are described in U.S. Pat. Nos. 1,683,708; 1,731,069; and 1,741,461.